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The search for the region’s healthcare heroes is over—for this year, as Jeetha D’Silva reports from Chennai

On 1 December the best of the region’s medical community gathered in Chennai to honour the doctors and teams that showed innovativeness and excellence in healthcare at the BMJ Awards South Asia 2018.

Competition for the awards, now in their fifth year, was intense, with 1575 nominations from nine countries—Afghanistan, Bangladesh, Bhutan, India, the Maldives, Myanmar, Nepal, Pakistan, and Sri Lanka—for 10 award categories (table).1

Taking the stage at the awards, Fiona Godlee, The BMJ’s editor in chief, said, “South Asia has many challenges, some unique, some shared.” The awards are a reflection of BMJ’s long term commitment in this region over the past decade and is part of BMJ’s vision to create a healthier world. “We are deeply impressed by the quality and commitment to your work; each one of you is a winner,” she said.

Prashant Jha, The BMJ’s senior editor, South Asia, said that the quality of entries had got better year on year. “This year, we made the road tougher at the start of the selection process, so we had a significant improvement in the quality of entries from phase 1. Also the judges had a tough time choosing the winner among the finalists, which is a good complaint to have,” he added.

Prashant Mishra, the managing director for BMJ India and South Asia, called the awards the “Oscars of medicine” and lauded the nominees who had made it to the finals.

Rigorous selection process

Earlier in the day, 30 finalists presented their work to a jury of clinicians, representatives of patients’ organisations, and members of the editorial team of The BMJ. The presentations marked the culmination of a rigorous selection process that had taken many months. Each entry was assessed for impact, novelty, regional relevance, patient engagement, and scalability. In the end, it was the projects that had most impact and the potential to influence change and improve health outcomes in South Asia that won.

Aparna Hegde, founder and managing trustee of ARMMAN, a Mumbai based not-for- profit organisation that promotes maternal and child health, said that presenting her project before the jury was an invaluable experience. “They knew all our pain points,” she said, smiling as she recalled the morning’s proceedings. Hegde’s project, mMitra (“m” stands for mobile and Mitra means friend), won in the Maternal and Child Health Team of the Year category. It’s a free mobile service that sends targeted information on preventive care through automated voice calls during pregnancy and early infancy.

mMitra was launched in 2013 and by July 2018 had reached 1.8 million women across many Indian states. The intervention addresses a lack of access to preventive care information that contributes to maternal and infant mortality in India. ARMMAN assessed the effect of the project from 2013 to 2018 and found a 22% increase in pregnant women who took iron and folic acid for 100 days, a 48% increase in infants who were exclusively breastfed, a 43% increase in proportion of infants who had their weight checked at least three times, and a 14% increase in infants who tripled their birth weight at the end of one year.2 Hegde added that the award validates the team’s work and “will help us get a much wider recognition for our work within the medical community.”

Reducing maternal morbidity and mortality

Maternal health was the focus of another award winning initiative, the Ending Eclampsia project from Bangladesh, which won Non-Communicable Disease Initiative of the Year. Kanij Sultana, senior research officer at the Population Council in Dhaka, told the jury that the project aimed to reduce maternal morbidity and mortality by increasing use of magnesium sulphate in primary care.

Many of the projects that won awards aimed to tackle large public health problems. The Infectious Disease Initiative of the Year Award went to a project that is striving to expand and strengthen tuberculosis control in tribal populations. “The prevalence of TB has been found to be more in the tribal population than in the general population,” said Avi Kumar Bansal, scientist at the National JALMA Institute for Leprosy and other Mycobacterial Diseases in Agra, India.

The project aimed to ensure that the tribal population had access to diagnostic facilities and drugs. Mobile diagnostic vans kitted out with a radiography machine and space for sputum analysis visited 6783 villages and reached a population of 6.1 million people, Bansal said. The project has improved access to healthcare services for the tribal population and is now being implemented on a larger scale. The jury was unanimous in selecting this project. “This is a compelling story,” said Buddha Basnyat, director of the Oxford University Clinical Research Unit in Nepal. “They are taking care of a really vulnerable population, and they are using technologically advanced testing as a diagnostic tool,” he added.

The Mental Health Team of the Year Award went to the department of psychiatry at the District General Hospital in Ampara, Sri Lanka, for a project that aims to improve efficiency of mental healthcare for patients with severe mental illness in rural districts in the east of country. Hiranya Wijesundara, a psychiatry consultant at the hospital, said, “This award could help us get more support, and we will use that to expand our services such as our rehabilitation unit and the community support centre.”

Recovery after colorectal surgery

This year Sri Lanka had two winners. The second award, for Surgical Team of the Year, went to a project on implementing a modified enhanced recovery after colorectal surgery (mERAS) protocol in a resource poor setting. Carried out by the surgery department at the University of Sri Jayawardenapura, the project has become the gold standard in the management of colorectal cancer, the fourth most common cancer in Sri Lanka. The benefits of the project include early mobilisation, reduced hospital stay, and lower mortality. A study by this team found the 30 day mortality to be zero. Bawanthe Gamage, senior lecturer at the university, said that he hoped that the awards will encourage young doctors. “Even though as a region we are lacking in resources, there is an enormous potential for healthcare practitioners,” he said.

The Post Graduate Thesis of the Year went to Zainab Hasan of the Dow University of Health Sciences in Karachi, Pakistan, for her study on the effect of routine deworming on the weight of 5-16 years olds in an urban slum of Karachi.

Kulesh Bahadur Thapa of the Nepal Ambulance Service, Kathmandu, won the Quality Improvement and Patient Safety team of the Year. The service is the first centralised and coordinated emergency medical service provider in the country.

Training in Myanmar

The Excellence in Medical Education Award went to Kyaw Myo of the University of Medicine, Myanmar, for its emergency paediatric care programme. It aims to reduce high child and neonatal mortality through targeted training programmes for medical and nursing staff in district hospitals in three Myanmar regions.

The Research Paper of the Year Award was given to Omesh Kumar Bharti, epidemiologist at the State Institute of Health and Family Welfare of the government of Himachal Pradesh, India, for his paper, “Injecting rabies immunoglobulin (RIG) into wounds only: a significant saving of lives and costly RIG.” The project was born out of necessity when there was little rabies immunoglobulin available and many patients requiring treatment. The 26 patients, who had been bitten by laboratory confirmed rabid dogs and who were treated with local injections, were followed up and found to be alive after a year.3

Vimarsh Raina, chief scientific officer, Chimera Translational Research Fraternity, New Delhi, India, won the Healthcare Innovation of the Year for robotic telemicroscopy. This novel system involves the use of information and communication technology and allows the pathologist to view and infer a diagnosis of a patient from a remote location. The system helps patients in remote locations access pathologists in urban super specialty laboratories and get a diagnostic inference directly in real time and can be a boon to healthcare in resource strapped areas. Raina believes that the award will help him bring effective diagnostic services to the masses. “Unless we are able to reach out, we cannot make a big difference to healthcare in the region,” Raina said.

As the winners stepped into the limelight, Jha said, contrary to what everyone might believe, the awards are not the culmination of their efforts. “The journey, in fact, begins tonight.”